aVR导联对急性下壁心肌梗死患者梗死相关血管判断的价值  

The value of lead aVR in identifying the infarct-related artery in patients with acute inferior myocardial infarction

作　　者：张彦周[1] 孙同文[1] 贾百泉[2] 邱春光[1] 李莉[3] 王乐信[1] 

机构地区：[1]郑州大学第一附属医院心内科,郑州450052 [2]焦作矿务局中央医院心内科 [3]郑州大学第一附属医院急诊科

出　　处：《临床心血管病杂志》2005年第4期214-216,共3页Journal of Clinical Cardiology

摘　　要：目的探讨心电图(ECG)对急性下壁心肌梗死(MI)患者梗死相关血管(IRA)判断的价值。方法选择2002年7月～2004年12月的急性下壁MI患者90例,回顾性分析其症状发作后24h内ECG改变。结果90例中,IRA为右冠状动脉(RCA)者70例,为左回旋支(LCX者)20例;Ⅰ导联ST段抬高和(或)V1和V2导联ST段压低提示IRA在LCX,而ST段抬高Ⅲ导联大于Ⅱ导联和(或)导联V4RST段抬高≥0.5mm提示IRA在RCA;aVR导联ST段压低≥1mm判断IRA为LCX,其敏感性为70.0%,特异性为94.3%。结论Ⅰ导联ST段抬高、ST段抬高Ⅲ导联>Ⅱ导联、导联V4RST段抬高≥0.5mm、V1和V2导联ST段抬高或压低以及aVR导联ST段压低等5项标准可用于判断急性下壁MI患者的IRA,而aVR导联ST段压低为一项新的标准。Objective:To investigate the electrocardiography(ECG) criteria for identifying the infarct-related artery (IRA) in patients with acute inferior myocardial infarction(MI).Method: We retrospectively studied 90 patients with acute inferior MI hospitalized between July 2002 to December 2004. The ECG recorded within 24 h of the onset of symptoms were analyzed. Result:There were 70 patients whose IRA were right coronary artery (RCA) and 20 patients whose IRA were left circumflex artery (LCX) among the 90 patients. ST-segmet elevation in lead Ⅰ and/or ST-segment depression in lead V_1 and V_2 indicated that IRA were LCX; ST-segment more elevated in lead Ⅲ than in lead Ⅱ and/or ST-segment elevation ≥~0.5 mm in lead V_4R implied that IRA were RCA; ST-segment depression≥1 mm in lead aVR had a sensitivity of ~70.0 percent, a specificity of ~94.3 percent for identifying LCX as IRA.Conclusions:ST-segment elevation in lead Ⅰ, ST-segment more elevated in lead Ⅲ than in lead Ⅱ, ST-segment depression or elevation in lead V_1 and V_2 ST-segment elevation ≥~0.5 mm in lead V_4R and ST-segment depression≥1 mm in lead aVR, above 5 criteria can be used for identifying IRA in patients with acute inferior MI. The presence of ST-segment depression in lead aVR is a new criterion.

关 键 词：心肌梗死 心电描记术 梗死相关血管 

分 类 号：R512.2[医药卫生—内科学]